Individual provider Active NPI

Samuel Aaron Young, CRNA

  • Certified Registered Nurse Anesthetist
  • Little Rock, AR
National Provider Identifier
1528428125
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C003143 Issued in AR
Practice address
2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone
(501) 664-4532
Fax
(501) 663-4335
NPI assigned
Feb 25, 2016
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R081215 AR
Certified Registered Nurse Anesthetist 367500000X C003143 AR Primary

Addresses

Primary practice location

2 Saint Vincent Cir
Little Rock, AR 72205-5423

Mailing address

500 S University Ave Ste 500
Little Rock, AR 72205-5307
Phone (501) 664-4532

Other practice location 1

4301 W Markham St
Little Rock, AR 72205-7101
Phone (501) 686-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160809001263 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507150851 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Arkansas for Medical SciencesGroup PAC ID 4082528955, shared by 29 NPIs, 1,159 clinicians
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

1 Childrens Way
Suite 653
Little Rock, AR 72202-3571
Phone (501) 364-1100

4301 W Markam St
Little Rock, AR 72205-7101
Phone (501) 686-8000

9601 Baptist Health Dr
Little Rock, AR 72205-6321
Phone (501) 202-2093

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R081215ARMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Jun 30, 2016 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jun 30, 2016 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Arkansas Health Group CurrentSince Aug 1, 2022 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jun 30, 2016 Accepting new patients
Southern Regional Anesthesiology Consultants PLLC CurrentSince Jun 1, 2018 Accepting new patients
Arkansas Health Group CurrentSince Aug 1, 2022 Accepting new patients

Locations

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Ste 653
Little Rock, AR 72202

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

500 S University Ave
Ste 500
Little Rock, AR 72205
Phone (501) 320-1101

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

4 Hospital Dr
Morrilton, AR 72110
Phone (501) 977-2300

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1528428125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE STE 500",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055307",
            "telephone_number": "501-664-4532",
            "fax_number": "501-663-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SAINT VINCENT CIR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055423",
            "telephone_number": "501-664-4532",
            "fax_number": "501-663-4335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SAMUEL",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-25",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R081215",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C003143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.